Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nicole S. Wagner, Ph D , LLC

Organization Clinical Psychologist · NPI 1053589135

Nicole S. Wagner, Ph D , LLC is a Clinical Psychologist in Lakewood, Ohio. Licensed in Ohio. Registered with an NPI since 2008.

Licensed in
OH
In the registry since
2008
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11740 Clifton Blvd Ste 202
Lakewood, OH 44107-2057
Phone: (216) 548-5469
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 6025 (OH)

Record details

NPI number1053589135
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nicole Wagner — Managing Partner · (216) 548-5469
NPI enumeratedFebruary 12, 2008
Last updated in NPPESFebruary 12, 2008
Mailing address11740 Clifton Blvd, Suite 202, Lakewood, OH 44107-2057

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